If you’ve been paying attention to the news you know that the perennial battle of the benefits of using diagnostic GI scopes versus the struggle to keep them properly disinfected is back again.
While the benefits of using the diagnostic instruments to peer deep into the digestive tracts of a patient is not in debate, the cost of technological advances in the scopes, some of which are being designed with high resolution cameras and surgical tools on the end, is that they are more difficult to keep clean.
And in an industry where disposable, single-use instruments is becoming the norm, there’s not much chance of a $40,000-diagnostic scope becoming a disposable tool in the near future, so education and awareness is the key to winning the battle against these killer bugs, say safety experts.
Recent outbreaks of antibiotic-resistant bacterial infections in hospitals in the Los Angeles and Philadelphia areas. In the first, officials at The University of California’s Ronald Reagan Medical Center were faced with an outbreak of carbapenem-resistant Enterobacteriaceae, or CRE, which is highly resistant to antibiotics and can kill up to 50% of infected patients. Then in early March, officials at Cedars-Sinai Medical Center in Los Angeles discovered that four patients were infected with CRE and 67 other people may have been exposed.
Here’s a quick list of what safety experts say you should be doing to keep your scopes clean:
Develop a checklist. Everyone from surgeons to emergency management folks are developing checklists for seemingly routine procedures. Why? Because they are only human, and we forget everything. With a process as complicated as it is for disinfecting GI scopes, experts say the best thing your facility can do is write the process and put in front of any staff that handles disinfection processes.
Never underestimate human error. Your staff—especially those who have been on the job for a long time—may think they know all they need to know about disinfection processes, but all it takes is one missed step by a distracted employee for an outbreak of a deadly infection to kill people, your reputation, and maybe the business at you clinic. Make proper practices the only way at your facility, and make sure that any tasked with scope disinfection focuses only on that task—and doesn’t get distracted with other patient care or administrative duties.
Your patients have been exposed more than you think. So, you think your clinic’s patients have escaped the dangerous bugs? Think again. Your facility should treat every single patient as if they could carry bugs from the common cold to HIV to hepatitis. Don’t pretend to know how to spot someone with an infection, don’t expect someone to be honest enough to tell you about it, and don’t let your GI scope disinfection processes fall behind.
Consult those who know best. Manufacturers of scopes provide written cleaning instructions in hard copy and online for a reason. They don’t people getting sick from being treated by their equipment, and they know their equipment better than you do. Download the written instructions, print them out, and place them in full view wherever reprocessing is carried out. Many manufacturers are now offering to send out representatives to train clinic employees in proper techniques; take advantage of this.
Make disinfection a team effort. During last year’s Ebola scare, the CDC recommended that hospitals and clinics being instituting teams of “spotters” that observe each other donning and doffing PPE when treating patients suspected of having the virus. The intent was simple: multiple pairs of eyes are better than one, and cuts down on the number of mistakes made. The same approach can be applied to your disinfection process for scopes. Perhaps you could try forming teams of two who go through the process together and check each other’s work, much the same as a pilot and a co-pilot do so in the airline industry.